| NPI | 1588654412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 47611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C54601) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2017-08-27 |